LEAH M WALLER (PA) – Medical Physician Assistant, NPI 1962873711

LEAH M WALLER (PA) is a healthcare provider. based in Vidalia, Georgia. specializing in Medical Physician Assistant. They hold the professional credentials PA. They hold a License No. 007734 (GA). The NPI Number for LEAH M WALLER (PA) is 1962873711

Main info

Female
11 Years Of Experience
Accepts Medicare Assignment
Name
LEAH M WALLER (PA)
NPI
1962873711
Phone
(912) 537-4986
Address
PO BOX 407
Enumeration Date
19 October 2015
Last Update Date
17 October 2019

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9125355555
Graduation Year
2015 (11 years ago)
PAC ID
4981914215
Group Practice PAC ID
0941296560
Professional Enrollment ID
I20151117000544
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience34
Completeness75
Years active:10State licenses:1Digital endpointsOther names

Provider Addresses for LEAH M WALLER (PA)

  • PO BOX 407

    VIDALIA, GA 304750407

    Phone: (912) 537-4986

    Type: Mailing

  • 1 MEADOWS PKWY

    VIDALIA, GA 304748759

    Phone: (912) 535-5800

    Fax: (912) 535-5830

    Type: Location

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $21.

Total Amount is formed as General ($21) + Research ($0) + Ownership ($0) = $21.

Last reported payment date: 2024-07-30 • Largest payer in this snapshot: Corium, LLC ($21).

Total Amount

$21

General + Research + Ownership

Payments

1

Total payment records

General Amount

$21

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-07-30

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Corium, LLC$21
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2015-11-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20151117000544IPhysician AssistantGATBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

Top Medicare procedures (2023) · refreshed 2026-05-27

HCPCSDescriptionServicesBeneficiariesMedicare allowed
99232Subsequent hospital care with moderate levelof medical decision making, if using time, at least 35 minutes19893$0
99223Initial hospital care with moderate level of medical decision making, if using time, at least 75 minutes10094$0
99239Hospital discharge day management, more than 30 minutes8686$0
99233Subsequent hospital care with moderate levelof medical decision making, if using time, at least 50 minutes6144$0
99238Hospital discharge day management, 30 minutes or less1414$0
View full utilization report →

Insurance plans in this area (ZIP 30475)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 0941296560View full group profile

Reviews

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Frequently asked questions

What unique ID ties claims to LEAH M WALLER (PA)?
NPI 1962873711 is assigned to LEAH M WALLER (PA) under the national enumeration system.
Is LEAH M WALLER (PA) active in the national directory?
LEAH M WALLER (PA)'s public NPI profile is in an active state.
What field does LEAH M WALLER (PA) work in?
You can think of LEAH M WALLER (PA) as practicing within Medical Physician Assistant. Clinical services aligned with this taxonomy classification.
What location metadata exists for LEAH M WALLER (PA)?
The page summarizes Vidalia, Georgia for LEAH M WALLER (PA); expand the address list for detail.
Does Medicare enrollment show here?
Medicare enrollment screens are separate from the basic NPI extract shown here.

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